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Reviewed research
Authors Daumler D, Chan P, Lo KC, Takefman J, Zelkowitz P.
Review Date December 2016
Citation Human Reproduction 2016; 31 (12): 2781–2790
Background
Most men express a desire to have children but many men may be unaware of factors that may impair their fertility. Male infertility is associated with impaired quality of life and poorer health status. However, few studies have focused on men’s knowledge of their own fertility. Studies of both men and women have found that men are comparatively less knowledgeable about issues of fertility and reproductive health.
Aim
To assess men’s knowledge of fertility, specifically with respect to the medical, environmental and psychological factors that are associated with male infertility, and where men receive their fertility information.
Methods
A regionally representative sample of Canadian men volunteered to complete a web-based survey of male fertility and reproductive health, over a 2-month period in 2015. Men aged 18–50 years, were recruited for the study by a market research company. Surveys were available in both French and English. Survey questions were designed by the researchers and included questions on demographics and fertility experience and risk factors for male infertility. Fertility knowledge was assessed through two open-ended questions and a comprehensive list of established and possible risk factors and attendant health issues. Knowledge scores between 0 and 100 were assigned for each man.
Overall knowledge scores were compared across levels of covariates separately and then independent associations were assessed using multiple regression analysis.
Results
701 men completed the survey, with a mean age of 34.1 years. Men were only able to identify 51% of the risk factors and 45% of the health issues associated with male infertility. Men were most aware of the modifiable risk factors for infertility (e.g. sexually transmitted infections, smoking cigarettes), relative to their knowledge of fixed risk factors (e.g. delayed puberty, size of testicles) and the attendant health issues (e.g. cardio- vascular disease, diabetes). The overall level of fertility knowledge did not vary by most demographic characteristics (e.g. age, education, employment, income), although men from ethnic minority groups displayed slightly greater awareness.
Younger men, those with lower incomes and those who had no desire to have children in the future were more likely to identify themselves as unaware of associations with infertility in the open-ended questions. Self-reported knowledge was significantly associated with higher overall knowledge scores.
More than half of the men expressed an interest in obtaining information about male fertility and reproductive health, with the majority of these men indicating that medical professionals and online sources were their preferred methods for receiving information.
Conclusion
The authors state this is the first large-scale survey that focuses solely on men’s knowledge of male fertility. Previous studies of fertility knowledge have either omitted men from their samples or when men have been included, they were asked about general fertility or women’s fertility.
Since there were not specific demographic groups that had lower knowledge scores, universal public education about male fertility is suggested. Insight into the areas where men’s knowledge may be lacking can inform strategies for disseminating fertility-related information and improving men’s fertility awareness.
Points to Note
- Although most men express a desire for fatherhood and male infertility can be a factor in half of the couples experiencing infertility, many studies on fertility focus on women only or include small samples of men with larger samples of women.
- An understanding of men’s knowledge of fertility and factors, both modifiable and non-modifiable, that can affect their fertility can help to guide health promotion and education programs on male fertility.
- This study showed that half of the men surveyed did not have very good knowledge of either risk factors for infertility or health conditions associated with infertility.
- Limitations of the study included: it was a volunteer sample of men and was therefore likely to include men with a particular interest in the topic; and some of the risk factors included in the survey were putative rather than proven risk factors and it might not be expected that the general public should be able to identify them.
- As shown in other studies, a preference for online information suggests ways for disseminating good quality information about male infertility.
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